Health care management

chela_

P4.pptx

Home >Business & Finance homework help >Operations Management homework help >Health care management

Electronic Records Management Project

Colorado Technical University

9/13/2017

Quality Improvement Program at the Eastern Idaho Regional Medical Center (EIRMC)

Eastern Idaho Regional Medical Center is a general medical and surgical hospital in Idaho Falls, ID, with 309 beds. Survey data for the latest year available shows that 108,734 patients visited the hospital's emergency room. The hospital had a total of 12,778 admissions. Its physicians performed 2,065 inpatient and 3,025 outpatient surgeries.

The healthcare industry has shown a history of constant discovery, progress and innovation thus the healthcare providers have become increasingly involved in the development and procurement of information technology, equipment, machinery, drugs, practices, policies and accreditation systems that guarantees the delivery of quality healthcare and mental services to the public.

The implementation of the electronic document and records management system is propelled by the increasing need for compliance, efficiency, effectiveness, and security the health care industry.

Change is an essential and fundamental component of any organization which seeks to be efficient and effective since it provides the opportunities for continuous improvement and evolution. This has led to the players in the healthcare industry switching from the previous chart system to the information technology supported electronic medical records systems which has the ability to store accurate, reliable, accessible and an immense volume of data while minimizing the costs on expenses.

The management of EIRMC recognizes and acknowledges that new systems of health care are essential for the enhancement and protection of the needs and welfare of the patients. The hospital has adopted and integrated new models and technology in an attempt to help the healthcare professionals to connect with their patients better since the recent changes in the healthcare industry emphasize on putting patients at the center of healthcare.

Electronic Records Management (ERM)

An Electronic Records Management (ERM) is an automated information system for the organized collection, processing, transmission, and dissemination of information in accordance with defined procedures.

The electronic document and records management system is a computerized system which maintains the creation, receipt, use, maintenance, and retention or disposal of documents and records thus effectively assisting the workflow processes of an organization.

These systems have numerous benefits such as the reduction of costs, the improvement of effectiveness, and the reduction of the time for data queries. They also help to keep information safe and secure, eliminating the chances of data loss, and the management of the integrity and reliability of data. These systems assist in the improvement of service delivery thus resulting in the general enhancement of business processes.

Conversely, there are risks which accompany the adoption and the implementation of an electronic documents and records management system such as the violation of data privacy and security provisions for safeguarding medical information as directed by the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Risks such as the risks of data corruption, loss, and alteration are as a consequence of the interaction between humans and computerized systems, the fear of change, lack of adequate knowledge on how to deal with the system, the lack of digital continuity, and data migration.

Organizational Assessment

This analysis helps to identify the organization’s strengths and weaknesses.

Before embarking on any change initiatives, it is important to understand overall business priorities and how well the organization is currently positioned to meet its objectives.

Therefore, the first step is to assess the current state of the organization through a combination of documents, surveys, interviews and/or focus groups. This analysis helps to identify the organization’s strengths and weaknesses, determine what changes will have the greatest positive impact.

It also helps to point out the potential areas of resistance or implementation barriers, so that corrective actions can be taken early on in the change process.

The solutions are focused on creating a high performance organizational infrastructure that drives operational excellence and optimizes human capital investments.

Organizational assessment is designed to provide the management of a company an organizational diagnosis and social change outlook to diagnose institutional strengths and weaknesses at the onset of development activities.

It examines all aspects of organizational performance, including the enabling environment, institutional capacity, management, financial viability, and staff motivation. It is therefore important that the management first examine the current organizational and political climate in an attempt to assess the readiness to sustain the implementation.

This examination includes:

• Identification of key stakeholders who share the interest and need for change

• Assessment of the degree to which these stakeholders perceive the issue or need to be a priority

• Willingness of leadership from multiple departments to support the change process over a period of time

• Identification of a leadership team responsible for the oversight of necessary aspects of the change process over time

• Desire to engage in discussions and gather information about potential solutions to identified needs

• Knowledge of implementation science and its application to the change process

The following five-step approach is essential in when performing an organizational assessment:

Project mobilization

Phase 1 data collection

Phase 2 data collection

Analysis and identification of strategic changes

Action planning

The following five-step approach is essential in when performing an organizational assessment:

1. Project Mobilization

During the start-up phase of the project, review background material, conduct project planning, and conduct initial meetings with all stakeholders to gain insights and discuss the project approach.

Deliverables: Work plan and kickoff briefing

2. Phase 1 Data Collection

The first phase of data collection will provide a holistic, big picture assessment of the organization. It is geared towards the identification of key stakeholders and the investigation of areas such as the external environment, and organizational culture, and any specific areas of interest and need to the organization.

Deliverable: Preliminary findings—key issues

3. Phase 2 Data Collection

This is driven towards data collection to gather more in-depth understanding around key issue areas to guide the development of alternatives and solutions.

Deliverable: Detailed findings

4. Analysis and Identification of Strategic Changes

After analyzing the more detailed data, the organization's management team is engaged in a process to identify strategic changes.

Deliverable: Analysis and alternatives

5. Action Planning

All the stakeholders collaborate with an organization's management team to develop action plans to address change priorities.

Deliverable: Action plans

Project Planning

The adoption and implementation of projects are preceded by planning while involves all the relevant stakeholders.

The purpose of the project planning phase is to:

Establish business requirements

Establish cost, schedule, list of deliverables, and delivery dates

Establish resources plans

Obtain management approval and proceed to the next phase

3. The basic processes of project planning are:

Scope planning – specifying the in-scope requirements for the project to facilitate creating the work breakdown structure

Preparation of the work breakdown structure – spelling out the breakdown of the project into tasks and sub-tasks

Project schedule development – listing the entire schedule of the activities and detailing their sequence of implementation

Resource planning – indicating who will do what work, at which time, and if any special skills are needed to accomplish the project tasks

Budget planning – specifying the budgeted cost to be incurred at the completion of the project

Procurement planning – focusing on vendors outside your company and subcontracting

Risk management – planning for possible risks and considering optional contingency plans and mitigation strategies

Quality planning – assessing quality criteria to be used for the project

Communication planning – designing the communication strategy with all project stakeholders

4. The articulation of the project objectives to be followed is tandem with the SMART rule:

Specific –Objectives are specific and written in clear, concise, and understandable terms.

Measurable – You need to know when you have successfully completed the task.

Acceptable – agreed with the stakeholders.

Realistic – in terms of achievement they must be centered in reality.

Time based – deadlines not durations.

Budget

There are direct and indirect stakeholders that are part of this project.

Direct stakeholders would be the government and creditors while the indirect stakeholders includes the community.

The community and vendors will be helping with financially in an attempt to accommodate the change to electronic funds.

There are grants that can be used to stay up to standards and the government allocates and gives the hospital each year to support the needs of the hospital. The government has the responsibility to ensure that the services provided to its citizens is of the highest quality possible. The government has the responsibility to regulate healthcare markets, develop the healthcare workforce, develop and evaluate health technologies and practices, support the acquisition of knowledge, and ensure the access to quality care for vulnerable populations.

The government is responsible for the provision and purchase of healthcare services, this has prompted the various levels of government to collaborate with stakeholders from across the healthcare system in order to ensure that the American public receives the best healthcare services available. The local, state and federal governments have formed strong partnerships with the private sector in order to achieve the ultimate goal in the healthcare industry which is the provision of high quality care. Eastern Idaho Regional Medical Center is among those entities to which the Idaho Department of Labor has committed funds to from its Workforce Training Fund.

Implementation Plan

The process involves:

The setting and revision of goals

Identification of the risks

The selection of the software development projects

The decision on when to launch process

Employee training and education

Plan Monitoring

This plan describes how to efficiently move from the organization's current state to their vision.

An implementation plan addresses the who, where, when, and how.

The five key components necessary to support implementation includes people, resources, structure, systems, and culture. All these components must be in place in order to move from creating the plan to activating the plan. Planning and the inclusion of all the relevant stakeholders ensure that the ideas of the team members are considered; it also ensures that all the team members are committed and have a sense of ownership in regards to the plan.

When change is implemented in an organization, it is often met with resistance thus in order to achieve successful change managers should focus on communication, training, and monitoring the workforce (Kerzner, 2017).

Sufficient resources are required to support the implementation process therefore, a realistic time commitment from staff to achieve a goal, a clear identification of expenses associated with a tactic, or unexpected cost overruns must be considered carefully.

People serve as the first stage of implementing a plan thus it is essential to make sure that the right people on board; people with the right skills and competencies.

The structure of an organization must be well defined; the structure of management and appropriate lines of authority. Consequently, the management of the organization needs to have clear and open lines of communication with its employees.

Meetings to review the progress should be scheduled depending on the level of activity and time frame of the plan to ensure that all the stakeholders are on the same page.

The management of the organization needs to include milestones into the plan, these milestones must then be achieved within a specific time frame.

The management of the organization needs to create an environment which has the capacity to connect employees to the organization’s mission and that makes them feel comfortable. Well organized teams are driven towards a data-based decision-making processAll the team members understand their job responsibilities and the right work processes thus they are able to apply their skills and talents more effectively to achieve business goals.

Implementation Strategy

Implementation is the process that turns strategies and plans into actions in order to accomplish strategic objectives and goals.

It includes:

Finalizing the strategic plan with all necessary personnel

Aligning the budget

Making the plan available for individual groups or team members

1. Goals serve as important input when planning the process implementation and help in answering questions such as:

Why are we falling behind our milestones?

What has changed since we laid out our plan?

What must change to get back on track?

How can we bring other resources into the equation?

2. Changing policies or guidelines, providing information and training alone are not adequate to bring about sustainable changes in practice. To adopt evidence-based practices, the implementation process must also address the organizational supports which are necessary to initiate and sustain the practices with fidelity.

3. Change is complex and dynamic. It involves moving or transforming from something familiar to something new. Change is only attainable through carefully planned implementation and the adoption of any new practices with the capacity to facilitate the system’s capacity for change.

4. Change management is geared towards the integration of changes without damaging the organizational culture or efficiency. It is driven towards the strategic implementation and management of change and the human element which accompany this process.

5. The implementation and management of change in an organization, therefore, should recognize the changes in the broader business environment and facilitate the development of the necessary adjustments for the needs of the company.

6. It should also be driven towards training employees on the appropriate changes and winning the support of workers thus it is critical that management of the organization shows support for changes and demonstrates that support when communicating and interacting with staff.

7. Education and training also play a vital role in helping the employees to understand and adapt to change in the workforce. When a new process or system is put in place, employees are likely to be unfamiliar with the process and its significance and application in their daily workflow thus training it is necessary to help employees become familiar with the change and how to adapt to it (Smither, Houston, and McIntire, 2016). The employees of the hospital are at the lowest level of the organizational structure, and they are responsible for the achievement of the vision and the mission of the organization. These individuals have specific job descriptions and duties which are geared towards the delivery of high-quality services as well as the protection and the enhancement of the welfare of the patients assigned to them.

8. Project monitoring is a necessary component of all project management plans; it is an essential step in the management of a successful change since it helps the management of the organization to see how the change is playing out in the organization.

References

EIRMC Hospital score Best hospital score

Average hospital

score

Training to improve safety 40 40 37.43

Effective leadership 110.77 120.00 115.47

Enough qualified nurses 82.35 100.00 96.48

Specialty trained doctors 100.00 100.00 42.98

Communication with doctors 3 5 2.98

Communication with nurses 3 5 3.27

Strengths Weaknesses Opportunities Threats

Largest regional Hospital ER wait times More efficient

Other hospitals being

built

334 beds

Communications Electronic records

Employee turn over

Multiple services

Filing system Better training Not enough training

Trauma service

Strengths	Weaknesses	Opportunities	Threats
Largest regional Hospital	ER wait times	More efficient	Other hospitals being built
334 beds	Communications	Electronic records	Employee turn over
Multiple services	Filing system	Better training	Not enough training
Trauma service

Running Head: HEALTH CARE MANAGEMENT 1 1. Electronic Filing System

1.1 Initiation

1.1.1 Evaluation & Recommendations

1.1.2 Develop Project Charter

1.1.3 Deliverable: Submit Project Charter

1.1.4 Project Sponsor Reviews Project Charter

1.1.5 Project Charter Signed/Approved

1.2 Planning

1.2.1 Create Preliminary Scope Statement

1.2.2 Determine Project Team

1.2.3 Project Team Kickoff Meeting

1.2.4 Develop Project Plan

1.2.5 Submit Project Plan

1.2.6 Milestone: Project Plan Approval

1.3 Execution

1.3.1 Project Kickoff Meeting

1.3.2 Verify & Validate User Requirements

1.3.3 Design System

1.3.3.1 Select an electronic system that will support the business process

1.3.4 Procure Hardware/Software

1.3.5 Install Development System

1.3.6 Testing Phase

1.3.6.1 Submit orders for review

1.3.6.2 Document decisions

1.3.6.3 Report on the status

1.3.6.4 Assess implementation of change orders when approved

1.3.7 Install Live System

1.3.8 Milestone: User Training

1.3.8.1 Document company’s standard operating procedures

1.3.8.2 Document employees understanding of electronic filing systems

Running Head: HEALTH CARE MANAGEMENT 1 1.3.8.2 Document employees understanding of electronic filing systems

1.3.8.3 Electronic signatures

1.3.8.4 Patients formation

1.3.8.5 Communication

1.1.1 Milestone: Making the switch

1.3.9.1 Move from paper to electronic

1.3.9.2 Document existing change process and map to electronic system

1.3.9.3 Document intent

1.3.9.4 Create a SOP standard operating procedures

1.3.9.5 Supremacy of electronic or paper documentation

1.3.9.5 Use of electronic signature

1.3.9.6 Employee access

1.3.10. Milestone: Document employee understanding and acceptance of policies an d

procedures on electronic filing system.

1.2 Control

1.2.1 Project Management

1.2.2 Project Status Meetings

1.2.3 Risk Management

1.4.3.1 Data security and user accounts

1.2.4 Update Project Management Plan

1.3 Closeout

1.3.1 Audit Procurement

1.5.1.1 Certify intentions to use electronic filing system

1.5.1.2 Electronic system meets security and FDA regulations

1.3.2 Document Lessons Learned

1.3.3 Update Files/Records

1.3.4 Gain Formal Acceptance

1.3.5 Archive Files/Documents

Central costs Year one Year two Year three

Labor 220,000 226,600 233,398

Consulting

Project management

Training support

Data Center

Hardware

Software license and fees

Storage and backup

Telecommunications

Application software

Annual maintenance fees

Hosting fees

Data warehouse costs

Integration

12,500

17,000

18,750

37,465

157,505

156,000

11,500

37,500

157,500

156,000

1,500

157,500

156,000

1,500

Total

cumulative

668,215

541,600

1,209,815

548,398

1,758,213

Central costs	Year one	Year two	Year three

Labor	220,000	226,600	233,398
Consulting Project management Training support Data Center Hardware Software license and fees Storage and backup Telecommunications Application software Annual maintenance fees Hosting fees Data warehouse costs Integration	12,500 17,000 18,750 37,465 157,505 156,000 11,500 37,500	157,500 156,000 1,500	157,500 156,000 1,500
Total cumulative	668,215 668,215	541,600 1,209,815	548,398 1,758,213

ARENA. (2017). Moving from paper to electronic Change management. Retrieved form

http://www.arenasolutions.com/resources/articles study./21cfrpart11-compliance/.

CIO. (2011). Electronic medical records cost stud. Retrieved from

https://www.ahcancal.org/facility_operations/hit/Documents/2011 -

02%20CIOC%20EMR%20Cost%20Study%20 -%20Final%20Release(v3)%2006 -

2011.pdf

Community Health Group. (2016). Quality Improvement Program Description. Retrieved fro m

http://www.chgsd.com/documents/QIProgDesc.pdf

Department and community of family medicine. (2016). Quality Improvement. Retrieved from

http://patientsafetyed.duhs.duke.edu/module_a/introduction/introduction.html .

Elsevier Inc . (2017). Journal of the American College of Surgeons . Volume 225, Issue 3, Pages

A1-A18, e1-e11, 361-454. Retrieved form

http://www.sciencedirect. com/science/article/pii/S1072751510000761 .

Elsevier Inc. (2017). Hospital costs associated with surgical complications: A report from the

private-sector National Surgical Quality Improvement Program. Retrieved from

http://www.sciencedirect.com/science/article/pii/S1072751504008105 .

EIRMC. (2017). Stakeholder voting Member Roster. Retrieved

http://www.heart.org/idc/groups/heart -

public/@wcm/@swa/documents/downloadable/ucm_453563.pdf .

EIRMC. (2017). Current updates. Retrieved form http://eirmc.com/service/er -trauma-flight-

icu?gclid=CJq95aeM7tUCFYGTfgodfjALiw&gclsrc=aw.ds&dclid=CKnZtqiM7tUCFQq

Jfgod-IgEpQ.

Fatkin, Kathy. (2017). Hipstory of the hospitals of Idaho falls. Retrieved from

http://eirmc.com/about/history.dot .

Goetsch, D. L., & Davis, S. B. (2014). Quality management for organizational excellence . Upper

Saddle River, NJ: pearson.

Haughton, J. (2017). Five Deming Principles That Help Healthcare Process Improvement.

Retrieved from https://www.healthcatalyst.com/5 -Deming-Principles-For-Healthcare-

Process-Improvement

HRSA. (2017). Quality Improvement. Retrieved from

https://www.hrsa.gov/quality/toolbox/methodology/qualityimprovement/

HRSA. (2016). Developing and Implementing a Quality Improvement Plan. Retrieved from

https://www.hrsa.gov/quality/toolbox/methodology/developingandimplementingaqiplan/

NAVEX. (2017). Improved Performance Pays off. Retrieved from navexglobal.com.

Kerzner, H. (2017). Project management metrics, KPIs, and dashboards : a guide to measuring

and monitoring project performance . John Wiley & Sons.

Smither, R., Houston, J., & McIntire, S. (2016). Organization development : Strategies for

changing environments. Routledge.

Swensen, S. J., Dilling, J. A., Mc Carty, P. M., Bolton, J. W., & Harper Jr, C. M. (2016). The

business case for health-care quality improvement. Journal of patient safety, 9(1), 44-52.

The Hospital Cooperate. (2017). At a Glance. Retrieved from

http://www.hospitalcooperative.org/wwwroot/userfiles /files/at_a_glance_121812_eirmc.

pdf.